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Nama Name

Alamat email Email address

Jantina Gender

Tarikh lahir Date of birth

Nombor kad pengenalan Identity card number

Alamat rumah Home address

Nombor telefon peribadi Private phone number

Pekerjaan Occupation

Jika anda telah bersara, apakah pekerjaan anda sebelum ini If you have retired, what was your previous occupation?

Pendidikan/Latihan Education/Training
DiplomaSarjana Muda/BachelorSarjana/MasterPhDTiada Kiatan/Not Applicable

Kemahiran Area of Specialisation

Kefasihan bahasa Language skills
Boleh menulis Writing ability
Melayu/MalayCina/ChineseTamilInggeris/EnglishLain-lain/Others
Jika kamu pilih lain-lain, sila nyatakan If you selected 'Others', please elaborate

Boleh membaca Reading ability
Melayu/MalayCina/ChineseTamilInggeris/EnglishLain-lain/Others
Jika kamu pilih lain-lain, sila nyatakan If you selected 'Others', please elaborate

Keanggotaan dalam parti politik, kesatuan sekerja dan/atau persatuan sukarela Membership in any political party, union and/or civil society group
Ya/YesTidak/No
Nama parti, kesatuan dan/atau persatuan, jika ada Name of the party, union and/or civil society group, if you chose 'Yes'

Isu-isu sosial, politik, ekonomi atau budaya yang menjadi minat pemohon Social, political, economic and cultural issues that you are interested in
Pendidikan/EducationBuruh/LabourEkonomi dan pembangunan/Economics and developmentDialog antara agama/Inter-religious dialogueHak asasi manusia/Human rightsAlam sekitar dan krisis iklim/Environment and climate changeSeni/ArtsJantina/GenderBelia/YouthSains untuk rakyat/Science for the peopleKesihatan awam/Public healthLain-lain/Others
Jika kamu pilih lain-lain, sila nyatakan If you selected 'Others', please elaborate

Hobi Hobbies

Sekira diterima menjadi ahli, apakah bidang yg ingin menceburi? If you're accepted as a member, which areas would you like to be involved in?

Adakah anda kenali mana-mana ahli Aliran secara peribadi? Do you know any Aliran member personally?
Ya/YesTidak/No
Jika ya, siapakah namanya? If yes, what is his/her name?

Bagaimana anda mengetahui mengenai Aliran? How did you hear about Aliran?
Laman web Aliran/Aliran websiteFacebookTwitterNewswav AppInstagramTelegramTikTokSecara lisan/Word of mouthSurat berita Aliran/Aliran newslettersWebinar Aliran/Aliran webinarsLain-lain/Others

Dengan klik Hantar, saya setuju saya telah membaca Prinsip-prinsip Asas Aliran dan menerima isi kandungannya. Submit the form to us after you have read and accepted Aliran's Basic Principles.